[Acute kidney injury]
SourceNederlands Tijdschrift voor Geneeskunde, 156, 50, (2012), pp. A5057
Article / Letter to editor
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Nederlands Tijdschrift voor Geneeskunde
SubjectNCEBP 14: Cardiovascular diseases; NCEBP 2: Evaluation of complex medical interventions
- 'Acute kidney injury' is modern terminology for a sudden decline in kidney function, and is defined by the RIFLE classification (RIFLE is an acronym for Risk, Injury, Failure, Loss and End-stage kidney disease).- Acute kidney injury occurs as a result of the combination of reduced perfusion in the kidney, systemic inflammation, and the administration of nephrotoxic drugs.- Patients with chronic renal damage, advanced age, diabetes mellitus or heart failure are at an increased risk of acute kidney injury.- In the short term, acute kidney injury leads to a markedly increased risk of death; the long-term effect of acute kidney injury is a permanent loss of renal microcirculation which could result in chronic renal disease.- Certain biomarkers in the urine offer new possibilities for detecting acute kidney injury in its early stage.- Treatment of patients with acute kidney injury is currently supportive in nature. The optimisation of a patient's haemodynamics results in a reduction of the occurrence of acute kidney injury during extensive surgical procedures.- A promising treatment aimed at preventing acute kidney injury is called 'remote ischaemic pre-conditioning'.
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